After-hours plan 'dangerous'

17:00, Aug 30 2012

Porirua's overnight medical clinic could be closed and replaced by roving paramedics.

The possible closure of the accident and medical clinic at Kenepuru Hospital from 10pm to 8am, seven days a week, has been labelled "dangerous" by an emergency doctor.

If it goes ahead, people would have to wait in their homes for medical treatment or drive to Wellington Hospital - something many low-income families could not afford, Rob Kieboom said.

"Never mind the well-off Wellington gentry who can pop down during the small hours to their brand spanking new $200 million hospital-cum-resort thingy, with overnight cafe and comfy seats. Infants and toddlers, the old and frail deserve better than this proposed insult for a medical service."

Dr Kieboom has worked at the clinic as a contracted doctor for five years and works one overnight shift each week, alongside two emergency trained nurses.

He questioned whether paramedics had the skills and equipment necessary to assess and treat acute patients in their homes.


"Paramedics are very good at trauma, but they're not medically trained . . . to the same degree and that's not an insult to them at all.

"Maori and Pacific Island children have high rates of meningitis, rheumatic fever, acute respiratory distress and sepsis [blood poisoning]. Older patients have a high incidence of strokes, heart attacks and acute abdominal pain.

"These sort of patients present to the centre overnight. These patients cannot wait for . . . a paramedic to come to their house."

He called on Porirua residents to "stand up for your right for this service, as once it's gone you will never get it back".

It is the last remaining overnight medical clinic in the Capital & Coast District Health Board catchment, which stretches from Wellington to Kapiti.

Chief medical officer Geoff Robinson said the clinic was well used during the day and early evening, but the overnight demand was low. The concept of delivering healthcare in homes would be more convenient, accessible and free for patients.

Porirua GP Larry Jordan said taking after-hours healthcare to homes was based on pilot projects in Kapiti and Horowhenua.

"The Urgent Community Care concept is part of a menu of services including telephone nurse triage, assessment, advice and advanced care paramedic home visit and ambulance services for emergencies which will be well co-ordinated."

Wellington Free had provided free round-the-clock services to Kapiti residents in their homes since 2009.

Dr Jordan is also the clinical champion for the Integrated Care Collaborative, an umbrella group for all hospital and community medical professionals in the region, who put the idea to the DHB.

"I'd like to emphasise at this stage it is only a concept, and the details have yet to be developed."

A working group involving GPs, health providers, consumers and community representatives was exploring the idea with a view to developing a detailed proposal.

Once that was developed, the Porirua community would be consulted, possibly in November, Dr Jordan said.

Porirua Mayor Nick Leggett said he would wait for the detailed proposal before deciding whether it was a good idea.

"If we can get a better service out of it for Porirua, then I would be in favour of it, but clearly questions have to be asked about how that happens, and what I wouldn't want to see is the community agreeing to something that would compromise community safety."

The Dominion Post